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Biliary Atresia Screening in India—Strategies and Challenges in Implementation

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To assess the utilization of SCC implemented in southern India and the effect on SCC utilization of face-to-face verbal education versus video-based content delivery.

Methods

The study included newborns with postnatal age of less than 2 wk at discharge. Mothers were administered SCCs and provided standardized verbal or video health education based on the time-period of enrollment. Home based monitoring of stool color and return of SCC on postnatal day 21 was advised. Telephone surveys were conducted to identify SCC use among families that did not return the SCC by post.

Results

Of the 2254 newborns enrolled, 1130 were in the verbal-counseling group and 1124 in the video-counseling group. No newborns with pale stools and biliary atresia were identified. SCC return rates were 3.8% and 2.8%. Comparing the verbal and video-counseling groups, there were no differences in the conservative (81.8% vs. 81.5%) and optimistic estimates (97.1% vs. 97.3%) of SCC utilization rates. Mothers with better educational status had higher optimistic estimates of SCC utilization.

Conclusions

The use of a validated SCC in Tamil with standardized information delivery leads to good utilization rates in southern India, with video content delivery being as effective as face-to-face verbal content delivery. SCC return by post is not a feasible mode of identification of card use.

Trial Registration

The study is registered under Clinical Trials Registry - India (CTRI/2018/01/011285).

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Acknowledgements

The authors thank the Health Promotion Administration, Ministry of Health and Welfare, Taiwan and Prof. Mei-Hwei Chang, College of Medicine, National Taiwan University for authorizing the Stool Color Card.

Funding

The study was funded by an intramural grant (JIP/Res/Intramural/phs2/2017–18).

Author information

Authors and Affiliations

  1. Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    Padma Sagarika Karri

  2. Department of Pediatric Hepatology, Leeds Children’s Hospital, Leeds, UK

    Barath Jagadisan

  3. Department of Preventive & Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    Subitha Lakshminarayanan

  4. Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    Nishad Plakkal

Authors
  1. Padma Sagarika Karri
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  2. Barath Jagadisan
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  3. Subitha Lakshminarayanan
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  4. Nishad Plakkal
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Contributions

PSK collected the data, analyzed and interpreted the data, prepared the manuscript; BJ conceptualized and designed the study, analyzed and interpreted the data, prepared the manuscript; SL designed the study and interpreted the data; NP interpreted the data; All authors contributed to the manuscript and approved the final manuscript. BJ is the guarantor of this paper.

Corresponding author

Correspondence to Barath Jagadisan.

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Ethical Clearance

The study had been approved by the institutional ethics committee that complies with international standards and is registered with the Government of India (JIP/IEC/2017/0248).

Conflict of Interest

None.

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Karri, P.S., Jagadisan, B., Lakshminarayanan, S. et al. Biliary Atresia Screening in India—Strategies and Challenges in Implementation. Indian J Pediatr 89, 133–140 (2022). https://doi.org/10.1007/s12098-021-03862-x

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  • DOI: https://doi.org/10.1007/s12098-021-03862-x

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